Thursday, June 27, 2013

I always knew my mother (while able to keep a secret -- I thought) had no filter. She gets it from my grandfather. But I thought she had a reasonable amount of common sense.

What, then, prompted her to tell three hundred incoming third-year medical students that her daughter (yes, the one at the SAME MEDICAL SCHOOL/RESIDENCY) is expecting via surrogate and is nine weeks along? And that she requires a surrogate because her aorta is a delicate flower waiting to dissect?

No, gentle readers, she did not first ask my permission. Nor did she tell me she had told them. I found out from a friend who is in the third year class.

Oh, and she also told them about how we had and lost Sweetpea.

I realize you all know this story. But I post anonymously, and there is only one person in my real life who knows of this blog's existence (who I doubt reads my posts and who knows me better than I know myself).

So there goes my grand plan of keeping all a secret until, G-d willing there is a baby. And what if this puts an Evil Eye on everything?

So here we are. Now what? Do I just hope people don't bring it up? Do I now have to start telling people? I don't want to tell people. I want to keep this secret because I am still terrified something could go wrong at any minute, and I don't want people asking how the baby is when the baby isn't.

Below is the email I sent my incoming team of interns and medical students with my expectations for the following Medicine Wards rotation.

Have I gone too far?

Hello to everyone, and welcome to (name of hospital) Floors Block One!

You will be working with me for the next month. It's going to be a busy month and we will all need to work hard, but we will learn a lot and (I promise) have fun.

YOU CAN CALL ME ANY TIME, DAY OR NIGHT, FOR ANYTHING!!! (phone number here)

I have a some expectations that I want to set out. I set a high bar but we have patients' lives in our hands and I take that responsibility seriously. It is a privilege and an honor that should humble us.

1. If you have questions, just ask! I almost never bite :o) Don't ever be afraid a question is too foolish because I promise I probably asked or will ask the same thing.

2. I do NOT expect perfection, but I do expect a COMMITMENT TO PATIENT CARE. That's what we're here for. You don't have to get it right but you need to do your best and know your patients.

3. Your history should focus on the chronology. Be complete. Do not copy others' histories but take your own because you can't trust other people's histories. You might need to call a nursing home or family member. Medical students, this is often a good way you can contribute to the team!

4. You will do proper physical exams. That means undress your patients! Examining through clothes is unacceptable. I expect a funduscopic exam on new patients and a basic neurologic exam (CN, DTRs, strength). Bandages are to be uncovered unless they are post-surgical and the surgical team hasn't yet changed the dressing. LOOK AT EVERY LINE/TUBE ON EVERY PATIENT EVERY DAY!

5. Patients' PCPs are to be contacted upon admission and discharge. Medical students, this is again a key responsibility for you.

6. Our team reviews primary data. This means: we do our own Gram's stains, review our own peripheral smears, examine our own urine sediments, and go to Radiology to review cases with the radiologist. I will help you find all of these places so don't worry :o)

7. We will pre-round in the morning, probably a half-hour prior to rounds but this may change depending what the team's needs are. On pre-rounds you will give me a brief update on the patient including the vitals from the last 24hrs, new test results, etc.

8. Update your nurses, and get updates from them! They are valuable resources particularly for patients who can't speak for themselves.

9. Eyeball all your patients at the end of the day. I promise it makes for much easier mornings.

10. Address code status. Obviously you don't need to have a lengthy discussion with the twenty-five year old admitted w cellulitis. But if somebody should be DNR, or should be hospice, address it! We can go over some techniques.

11. Read something every day. It doesn't have to be long. But otherwise you won't grow.

12. Interns, I expect you to TEACH YOUR STUDENTS!

13. Students, ASK QUESTIONS!

14. PLEASE LET ME KNOW if there is ANYTHING I can do to enhance your experience, teach you better, etc. I hope to go into academic medicine so I want to learn as much as I can about teaching.

Well, dear readers, what do you think? I am still learning this Senior Resident thing.

In other news...still terrified something will go wrong with intermittent moments of relief. Don't want to go to bed late so will elaborate later.

Thursday, June 13, 2013

Surrogate had a repeat ultrasound today...and there is a little embryo measuring 7w1d with a heart rate of 145!

We still have thirty-three very nerve-wracking weeks to go, but thank you to Hashem for granting me at least this. Maybe G-d really does hear my prayers. I guess being at the Kotel (Western Wall) doesn't hurt.

Husband and I continue to have a wonderful time, and I may have eaten WAY too much popcorn while watching a wonderful new Israeli movie tonight called פלאות (Wonders) starring Adir Miller. I highly recommend it, by the way. (The movie -- not the popcorn binge).

I will also soon post pictures of a wonderful hike we did in the Ayun Wadi, aka נחל עיון or נחל תמנון. Absolutely beautiful! But it's late, and we have a fairly long drive tomorrow to Beer Sheva. Will update soon.

Have a wonderful weekend everyone and Shabbat Shalom if it applies :o)

Saturday, June 8, 2013

Hello everyone -- or should I say "Shalom," or perhaps the more frequently used "allo," or even ma nishma?

I want to thank you for your support. We are still waiting for news, which will be late this week. Right now Surrogate is still having some symptoms which I hope is a good thing. And I think also no news is good news, right?

Meanwhile, we are keeping very busy and trying to enjoy ourselves. We had a hot and sweaty but very fun time in Tel Aviv, are now in the Krayot, and will be visiting Jerusalem next. I will put a note in the Kotel (the Western Wall) according to Jewish tradition -- essentially a written prayer to G-d. I am happy to include anyone else's hopes/prayers too if you want; just leave me a comment. Today Husband's parents had a bunch of friends/family over for lunch (very yummy and way tooo much food -- and killer cake!) and in the afternoon Husband and I met friends at the beach (and I even tried my hand for the first time at "matkot" (a sort of beach ping-pong game), followed by the new Star Trek movie. I will post more details but it's after 0100 and I want to get some rest.

In the meanwhile, check out the beautiful "Yerushalayim Shel Zahav" with Shuli Natan as the singer, song written by Naomi Shemer. I'm sure there are many Youtube links and let me tell you, it truly does describe the city especially in the late afternoon.

Wednesday, June 5, 2013

Riddle of the day: What is more fun than four failed IVFs with three lost babies? Why, five failed IVFs with four lost babies, of course! And for extra fun, how about having that loss occur when you're in Israel, far from your support network, and every SINGLE one of your couple-friends has at least one baby and some have two.

I have been quiet, dear readers, because I was afraid to put an Evil Eye on this last cycle. We transferred two embryos on 9 May and got a beta-hCG of 64 on 20 May. Our repeat beta-hCG on 22 May was 166. Our dear surrogate started having symptoms - mild ones, so I was glad she wasn't suffering -- but enough that I thought things might be working out. But I didn't want to announce anything even to the blogosphere.

But on 3 June, which was the 6-week scan, our little one measured on 5w1d and there wasn't a heartbeat. Of course it's very early but to measure so behind is concerning.

Surrogate is scheduled for a repeat ultrasound next Thursday. Nobody is very hopeful, though. Dear readers, do any of you know of a similar case which ended in success? I am already assuming this is a lost baby but am trapped in limbo.

I'm not sure what our next step will be. We have six frozen embryos but I don't want to proceed without first having a WTF conversation with the doctor. I also need to figure out how many more cycles, losses, I can take. Husband remains stupidly, steadfastly opposed to adoption.

So meanwhile, we have another week and a half of "fun" in the very hot Israeli sun. We actually have had a pretty nice time thus far. We're at a lovely boutique hotel in Tel Aviv and have been to the beach, walked Sheinkin, and eaten hummus at Abu Hassan. (Those in the know, know. And those who don't -- get your tush to Jaffa and order a plate!) We have also of course spent time with Husband's family and friends, and tonight we are meeting his friends at a fancy steak restaurant. Husband's niece and nephew are absolutely adorable. They're both school aged and I helped his niece with her homework the other night. She is a bit impish but I like that about her. Nephew is a little energizer bunny -- he doesn't stop moving :o)

Turner's Syndrome-related links

About Me

Yes, I really did get married in scrubs. But it was the 2.5th time, and to the same guy.
My lab coat is the one with the bottomless pockets. And yes, I really do need everything in them.
Talents include the ability to peel my weight in potatoes and onions, and to run for a code in heels and be first on the patient.
Weapons of choice: Panoptic ophthalmoscope, Littman Cardio III stethoscope, and my matza-ball soup of bi-continental fame.